Shortening of bones has been done utilizing various cutting means to perform a "step down" osteotomy. The same type of osteotomy is used for lengthening bones but is accomplished in an incremental manner of approximately 1 mm per day in a framelike device that slowly moves the osteotomy.
The step down osteotomy is as follows: a cut is made in a bone, then second cuts are made removing sections of bone. The bone is then moved in, thus filling the spaces of the removed bone. The elongation procedure is the same but without the second cuts, followed by moving and pinning grafts are often necessary.
Opposite half transverse cuts are joined by a lateral longitudinal cut. Ends are slid apart along the axial cut at an elongation rate of 1 mm per day. Shortening requires parallel half transverse cuts and removal of bone pieces between the adjacent cuts.